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Organization
REVIVE ROOTS PHYSICAL THERAPY
Active
Organization
REVIVE ROOTS PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAILY KETANBHAI SHAH MPT (PRESIDENT)
(510) 936-4392
Entity
Organization
Contact information
Practice address
32145 ALVARADO NILES RD STE 202, UNION CITY, CA 94587-2930
(510) 961-0361
Mailing address
32145 ALVARADO NILES RD STE 202, UNION CITY, CA 94587-2930
(510) 961-0361
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
08/05/2025
Last updated
08/05/2025
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